WO2001093172A1

WO2001093172A1 - Doctor service provider

Info

Publication number: WO2001093172A1
Application number: PCT/US2001/017836
Authority: WO
Inventors: Satyan G. Pitroda
Original assignee: C-Sam, Inc.
Priority date: 2000-06-01
Filing date: 2001-06-01
Publication date: 2001-12-06
Also published as: AU2001275136A1

Abstract

A method of collecting and distributing medical information at a computer server is provided. The method includes the steps of establishing computer network communications between the computer server (24) and a plurality of medical institutions (28, 30, 32, 34, 36), establishing electronic communication between the computer server (24) and a medical transaction device (42), creating a database of medical information on the computer server (24) relating to a plurality of patients with information received from the medical institutions (28, 30, 32, 34, 36) and the medical transaction device (42), and providing access to the database of medical information via the medical transaction device (42). The step of creating a medical database may further comprise the computer server receiving information from the plurality of medical institutions (28, 30, 32, 34, 36). The step of creating a medical database may also further comprise the steps of formulating a query for medical information, transmitting the query for medical information from the computer server (24) to at least one medical institution (28, 30, 32, 34, 36), and receiving medical information at the computer server from the queried medical institution (28, 30, 32, 34, 36).

Description

DOCTOR SERVICE PROVIDER

Background

A great deal of interest has been generated in automated Health Management Systems, due in part to the increase in popularity of the Internet. Many of these efforts are directed towards large systems for hospital, insurance and pharmaceutical companies, as well as toward moving information on the Internet. However, known systems have not provided a physician-centered model which provides access to information while eliminating duplicative record keeping.

Medical practitioners may be faced with numerous inefficiencies in the entering and processing of information relating to medical treatments. For example, information regarding health care administered to a patient often times sets off duplicative entry of such information, often times on incompatible information systems and databases. A physician making rounds at a hospital, for example, may visit a patient and prescribe a medication. Typically, the physician would enter a written record of his or her visit and prescription on paper, and return that written information to the physician's office. Clerical staff at the physician's office would then re-enter the information in the office record keeping system for billing purposes and for submitting claims to a health insurance company. The clerical staff would also separately enter the visit and the prescription in the medical records for the patient. Separately, a pharmacy at the hospital would fill the prescription, and the pharmacist, or clerical staff for the pharmacist, would also enter information in the patient's record regarding the prescribed medication. The pharmacy would also generate its own billing paperwork for the patient's health insurance company. Also, once information is entered in various databases, such information is not necessarily easily accessible by a physician. In the above example, the attending physician would not necessarily have on-demand access to the records stored at the physician's office, the records of the pharmacy at the hospital, or the records maintained by the patient's insurance company. Moreover, even if access were available, such records may be stored in various formats optimized for the use of the maintainer of the records, not for use by the physician.

Summary

A method of collecting and distributing medical information at a computer server is provided. The method includes the steps of establishing computer network communications between the computer server and a plurality of medical institutions, establishing electronic communication between the computer server and a medical transaction device, creating a database of medical information on the computer server relating to a plurality of patients with information received from the medical institutions and the medical transaction device, and providing access to the database of medical information to via the medical transaction device. The step of creating a medical database may further comprise the computer server receiving information from the plurality of medical institutions. The step of creating a medical database may also further comprise the steps of formulating a query for medical information, transmitting the query for medical information from the computer server to at least one medical institution, and receiving medical information at the computer server from the queried medical institution. The step of creating a medical database may also further comprise formatting the received medical information for access by a medical transaction device. The step of creating a medical database may also further comprise receiving information from a medical transaction device. The step of creating a medical database may also further comprise entering information on a medical transaction device and transmitting the information from the medical transaction device to the computer server.

The step of providing access to the database of medical information to via the medical transaction device may further comprise identifying a physician associated with the medical transaction device and restricting access for the medical transaction device to records of patients associated with the identified physician.

The medical information may comprise patient history, laboratory test results, X-ray images, microbiology test results, pathology test results, surgical history, insurance information, and billing information. The medical information may also comprise prescription information entered on a medical transaction device.

The medical transaction device may comprise a plurality of medical transaction devices. Also, the step of establishing electronic communication between the computer server and a medical transaction device may further comprise establishing wireless communications with the medical transaction device.

The plurality of medical institutions may comprise at least a hospital, an office associated with a physician, a pharmacy, a laboratory, and an insurance company.

In another aspect of the present invention, a method of collecting and distributing medical information at a computer server may comprise displaying a list of patients on a medical transaction device, selecting a patient from the list of patients, retrieving medical information relating to the selected patient from the computer server and displaying the information on the medical transaction device, entering medical information on the medical transaction device relating to the selected patient, and transferring the entered medical information from the medical transaction device to the computer server.

Brief Description of The Drawings

Figure 1 is a block diagram of one example of a DSP in relation to a Medical Transaction Device and various medical institutions.

Figure 2 is an illustration of an example of a Main Menu for a medical transaction device.

Figure 3 is an illustration of an example of a sub menu for a medical transaction device relating to Patient information. Figure 4 is an illustration of an example of a sub menu for a medical transaction device relating to Laboratory information.

Figure 5 is an illustration of an example of a sub menu for a medical transaction device relating to X-Ray information.

Figure 6 is an illustration of an example of a display for a medical transaction device relating to prescriptions.

Detailed Description

A network for providing access to medical records 20 is illustrated in Figure 1. At the center, a Doctor Service Provider 22 (DSP) 22 is a general purpose computer network server configured to receive, process, and transmit medical information. The DSP 22 includes a data storage element 24, which may be one or more hard disk drives, tape drives, optical drives, or any other suitable storage medium. The DSP 22 may also be associated with a knowledge based expert system 26. The DSP 22 maintains computer network communications 38 with various medical institutions, such as but not limited to a physician's office 28, hospitals 30, pharmacies 32, laboratories 34, and insurance companies 36. Computers network communications 38, with the various medical institutions may be accomplished through intermediaries, such as electronic clearing houses or computer service providers. The computer network communications 38 may include the Internet, fixed wireless, and conventional telephone communications. The DSP 22 also maintains mobile computer communications 40 with handheld medical transaction devices 42 and electronic data entry tablets ("eTablets") 44. The mobile computer communications 40 may be by wireless telephony, such as CDMA (Code Division Multiple Access) wireless data, GSM wireless data, CDPD (Cellular Digital Packet Data) wireless data, and other PCS services.

More than one DSP 22 may service an area. A physician may subscribe to one or more DSP 22s, and provide the DSP 22s with the identities, identification numbers, and information release authorizations from patients for whom information will be processed by the DSP 22. It is contemplated that a DSP 22 will charge a fee for the services provided, either on a flat monthly fee, by the quantity of information processed, or a combination of the two .

The DSP 22 is configured to process information in databases maintained by the medical institutions and provide the information to a physician. The DSP 22 may access all existing systems and databases at a Physician's Office/Clinic, Hospital, Pharmacy, Laboratory, and Insurance Company.

Many medical institutions are storing information in a standardized format known as "HL-7." The DSP 22 may be configured to "pull" such information, that is, request information regarding patients identified by a physician. Also, the DSP 22 may be configured to receive a "push" of information from a medical institution. Generally, confidentiality of medical information requires authorization by a given patient prior to information transfer from a medical institution.

The example of the physician's office as a medical institution is an example where a "push" may be employed. A physician may desire that all records regarding his or her patients be available on the handheld medical transaction device. In this example, every record entered by the physician's office would automatically be transferred to the DSP 22 for access by the physician. The DSP 22 would not request the information, it would be "pushed" by the physician's office to the DSP 22.

The example of a health insurance company as a medical institution is an example where a "pull" may be employed. A health insurance company may simply process too many records relating to too many patients to consume the processing capability, data storage, and bandwidth to sort records, determine which patients have a physician subscribing to a DSP 22, and automatically transfer all responsive records to various DSP 22's. In this example, information relating to a specific patient may be requested by a physician from a DSP 22. The DSP 22 would then formulate a query, contact the insurance company, extract the requested information, and forward the requested information to the physician.

Regardless of whether the information is collected by "pull" or "push," the DSP 22 is configured to filter and format the received information to enhance the information's usability to the physician. For example, the DSP 22 is configured to reformat data received from numerous sources to provide a consistent, uniform appearance to a physician. Also, the formatting is optimized for display on a handheld medical transaction device. Also, the physician may set filters to eliminate unnecessary information from detracting attention or storage space from the desired information.

It is contemplated that plurality of DSP 22's will co-exist. A physician may subscribe to one or more DSP 22's, and contract for database storage and maintenance. A DSP 22 may be the focal point for all information exchange for Doctor with other institutions on health/patient management.

A physician may exchange information with the DSP 22 by way of the medical transaction device 42 ("MTD"). MTD 42 may be any one of a number of hardware platforms. For example, wireless telephones having data entry and display capabilities are becoming available and may provide a suitable platform. Some wireless telephones have integral internet, access. Additional hardware platforms for MTD's 42 include handheld computing devices, such as devices operating the Palm OS operating system, the

Windows CE operating system, and others. Preferably, the MTD 42 has . wireless data receive and transmit capabilities. Alternatively, information may be exchanged on a cradle linked to a computer network. The MTD 42 may provide physicians with handheld wireless devices having handwriting recognition, voice recognition, cellular telephone access, and infrared and proximity RF interfaces.

The MTD 42 is configured to allow physician to record healthcare services rendered, including patient billing information, at the point where the care is given. The MTD 42 is also configured to allow a physician to enter additional information relating to a patient's healthcare, such as procedures recommended, prescriptions for medication, diagnoses, status reports, test results, etc.

The information entered by the physician is transmitted to the DSP 22. In the illustrated embodiment, the transmission of information is accomplished wirelessly. The DSP 22 receives the information, and may be configured to automatically push the information to one or more of the following locations: the physician's office; to an insurance company, a pharmacy, a hospital, etc. Records are stored with the last dated or most recent record available first (last in first out), with the option to access all previous stored records. In addition to data entry, the MTD 42 is configured to provide retrieval of medical records for the patients of a physician. The user interface for the MTD 42 is a menu system. For example, referring to Figure 2, the main menu page 50 may include selections for Personal 52, Patient 54, Hospital 56, Laboratory 58, Pharmacy 60, Insurance Company 62, Office 64, Billing 66, and Education 68. Selecting Personal 52 provides access to personal records of the physician, such as, pertinent addresses including office/clinic, various hospitals they visit, home and others. The screen also prompts a physician to enter pertinent phone, wireless/cellular and pager numbers, birth date, social security number, drivers license numbers. Apart from this basic information, the Personal page may also prompt a physician to enter their various Bank Account numbers with their respective balances, Investment Information with the various portfolio and balance information, other Credit / Debit / Bank Card numbers, their issuers and credit limits, Mortgage and Loan information. This allows the physician to store and access all their important personal information in a single place. See for example, U.S. Patent Nos. 5,590,038 and 5,884,271, which are incorporated by reference.

The physician may also be required to specify a security code or password for accessing the information with the DSP 22 - their Personal data, Patient related data or the information provided by the DSP 22 through the Value Added Services.

Selecting Hospital 56 provides access to records of various Hospitals by Name, Phone Numbers, Address and Hospital URL (a "direct click link"). The physician Access Codes for the respective sites are stored and displayed for convenience. The physician may access the existing Hospital sites through the DSP 22. The individual Patient information would be available from the Hospital (amongst other institutions) through the Patient screens.

Selecting Laboratory 58 provides access to the various Laboratories by their names, phone numbers, addresses and laboratory URL. The physician's Access Code for the respective sites are stored and displayed for convenience. Selecting Pharmacy 60 provides access to various pharmacies by their names, phone numbers, address, and pharmacy's URLs. The Physician's Access Codes for the respective sites are stored and displayed for convenience. This allows the Physician to access the desired Pharmacy 60 by either of the above fields, and write out a Prescription. Selecting Insurance Company 62 provides access to various Insurance Companies by name, phone number, address and URL. The Physician's respective Access Codes for the sites are listed for convenience.

Selecting Office 64 provides access to records of the physician's office. The Office selection may also be used by an office administrator, with access to either the DSP 22's "house-keeping" modules for the physician's office, or the existing systems in place. A finance module may allow the administrator to access all office related financial and accounting information, - such as business accounts, accounts payable / receivable for office related expenses etc. A Schedule / Appointment Book may be provided for Patient appointments —a patient may be provided with the option of placing appointments either on-line or through an Office Receptionist. In this example, a patient will be able to view the open or available slots on the physician's schedule and request an appointment. The Office Administrator will be able to review the appointments, set flags (restrict further appointments for certain patients etc.) and manage the consolidated appointments. The Personnel module allows the Administrator to address the Human Resources issues of Office employees - Vacations taken, Expense reports (which would also be accessed through the Finance Module, etc.), Periodic Reviews etc. Selecting Billing 66 provides access to the consolidated Billing details on all their Clinic Patients, or Specific Patient details. The users can access the records either through the Patient records, through Accounts Payable records or through Accounts Receivable records. Alternately, the physician may search for a specific Patient Billing summary by the patients Name, Social Security Number or Category (i.e. for a Patient, or Employee etc.).

Selecting Education 68 provides access to educational materials. The DSP 22 may be configured to periodically seek, update and organize resources on seminars, various organizations & research institutes, medical journals, medical news and updates — essentially forming a consolidated medical reference site. There is also an option to go into a list of favorite sites and a special link for the user to customize.

In addition to the information relating to medical services and patients, the DSP and MTD may be configured to provide additional services. For example, a Shopping Service may be configured to allow subscribers to make product and service purchases, without having to deal with loss of personal information / privacy, time lost gathering information, and dealing with Tele- Marketers, Sales and Marketing personnel. Screen 2.2a prompts the subscriber to enter personal information which is guaranteed confidentiality, and then prompted to enter the details regarding the Product / Service they wish to purchase. The DSP 22 will house internally various Product and Service profiles from partnering Vendors, or alternately will seek and organize the requested information for the subscriber to review. The DSP 22 also provides various on-line Catalogs and other Shopping Sites, along with a Special link for customization.

Selecting an item on the main menu may lead to a sub-menu, or a series of sub menus. For example, referring to Figure 3, an example of selections available under a sub-menu for Patient 54 may include History 70, Laboratory 72, X-Ray 74, Microbiology 76, Pathology 78, Surgery 80, Personal 82, Insurance 84, and Billing 86. The example menu in Figure 3 allows a physician to either search for Patient information by entering a Name, Social Security Number or the Date last Examined, or go into the complete records stored in the DSP 22.

Selecting History 70 provides access to the record of past examinations the patient would have under gone, at the same clinic or by any other specialist or physician (subjective to prior details given to the DSP 22 to access, structure and store pertinent Patient data). Selecting Laboratory 72 provides access to records of the laboratory results. Activating the Laboratory button may lead the physician to a Laboratory menu 88 illustrated in Figure 4. The Laboratory menu 88 includes options for selecting laboratory results from CBC, Urine, Stool, and Others. Laboratory results may be searched by patient name, identification number, or date of examination.

Selecting X-Ray 74 provides access to records of all the X-Ray images. The X-Ray images may be stored electronically, supported by text, handwritten, or voice notes relating to summaries and diagnoses. Selecting X- Ray may also lead the physician to an X-Ray menu 90 illustrated in Figure 5, which provides access to records by various categories such as CT, MRI, Cardio-Vascular, and etc.

Selecting Microbiology 76 provides access to records of microbiological tests conducted and their respective results. Selecting

Pathology 78 provides access to records of pathological tests conducted and their respective results. Selecting Surgery 80 provides access to records of the various surgeries conducted on the Patient, their outcomes, any complications, further diagnosis & prescriptions etc. Selecting Personal 82 provides access to personal information records on the patient, such as the patient's address, phone number, social security number, family members, etc. Selecting Insurance 84 provides access to insurance policy related records on the patient. Selecting Billing 78 provides access to billing records, including such information as insurance policy coverage information, past payment history, any outstanding balances, credit history etc.

Also, selecting an item from the main menu may lead to an action-type screen. For example, selecting Pharmacy may lead to a screen, such as Figure 6, where a physician may view the pertinent patient field, write a prescription on the screen, and send the prescription directly to a Pharmacy. In the hospital visit example, the MTD may be configured to display a list of patients from a pull-down menu. A physician may select a patient to visit, and the MTD will access the DSP 22, retrieving information relating to the patient, prior to the visit. The physician may in this way be advised of the latest developments concerning the patient. The DSP 22 may be configured to receive such information from the hospital where the patient is presently located, additional hospitals where the patient may have received care, the physician's office, as well as other medical institutions.

After the physician prescribes the medication, hospital staff, such as a nurse, may obtain the medication from a pharmacy and administer the medications at the prescribed intervals. The pharmacy may enter the prescription in its database and prepare a bill for the patient or the patient's insurance provider. The staff administering the medication may enter the relevant information on an eTablet, including the identity of the patient (name or by identification number), time that the medication was given, and dosage given. The eTablet electronically transfers the information to the hospital's databases for record keeping and cost recovery purposes. The records of the medication being provided by the pharmacy and administered by the hospital staff are transmitted to the DSP 22, either by the hospital pushing the information or by the DSP 22 pulling the information. Once at the DSP 22, the physician has access to the patients records that confirm that the prescription was filled by the pharmacy and administered by the hospital staff.

During the visit, the physician may select "Hospital Visit" from a selection of services offered. The doctor may also select "prescribed medication," and enter the medication and dosage prescribed. Upon completion of the entry of information the MTD transmits the information to the DSP 22, which updates its databases. The DSP 22 relays the information to the physician's office. Clerical staff at the physician's office may use the information to update the patient's records, generate bills, and generate insurance reimbursement requests without duplicative entry of the information. Alternatively, the DSP 22 may relay the information to an insurance company or an electronic clearing house relating to an insurance company. In this alternative, the insurance company may be billed for services rendered without the involvement of the staff at the physician's office.

Claims

What is claimed is: 1. A method of collecting and distributing medical information at a computer server, the method comprising: a. establishing computer network communications between the computer server and a plurality of medical institutions; b. establishing electronic communication between the computer server and a medical transaction device; c. creating a database of medical information on the computer server relating to a plurality of patients with information received from the medical institutions and the medical transaction device; and d. providing access to the database of medical information to via the medical transaction device.

2. The method of claim 1 wherein the step of creating a medical database comprises the computer server receiving information from the plurality of medical institutions .

3. The method of claim 1 , wherein the step of creating a medical database comprises: a. formulating a query for medical information; b. transmitting the query for medical information from the computer server to at least one medical institution; and c. receiving medical information at the computer server from the queried medical institution.

4. The method of claim 3, wherein the step of creating a medical database further comprises formatting the received medical information for access by a medical transaction device.

5. The method of claim 1 , wherein the step of creating a medical database further comprises receiving information from a medical transaction device.

6. The method of claim 1 , wherein the step of creating a medical database further comprises: a. entering information on a medical transaction device; and b. transmitting the information from the medical transaction device to the computer server.

7. The method of claim 1 , wherein the step of providing access to the database of medical information to via the medical transaction device further comprises a. identifying a physician associated with the medical transaction device; and b. restricting access for the medical transaction device to records of patients associated with the identified physician.

8. The method of claim 1 , wherein the medical information comprises at least one of the group of: patient history, laboratory test results, X-ray images, microbiology test results, pathology test results, surgical history, insurance information, and billing information.

9. The method of claim 1 , wherein the medical information comprises at least patient history, laboratory test results, X-ray images, microbiology test results, pathology test results, surgical history, insurance information, and billing information.

10. The method of claim 1 , wherein the medical information comprises prescription information entered on a medical transaction device.

11. The method of claim 1 , wherein the medical transaction device comprises a plurality of medical transaction devices.

12. The method of claim 1 , wherein the step of establishing electronic communication between the computer server and a medical transaction device further comprises establishing wireless communications with the medical transaction device.

13. The method of claim 1 , wherein the plurality of medical institutions comprises at least a hospital and an office associated with a physician.

14. The method of claim 1 , wherein the plurality of medical institutions comprises at least a hospital, an office associated with a physician, a pharmacy, a laboratory, and an insurance company.

15. A method of collecting and distributing medical information at a computer server, the method comprising: a. displaying a list of patients on a medical transaction device; b. selecting a patient from the list of patients; c. retrieving medical information relating to the selected patient from the computer server and displaying the information on the medical transaction device; d. entering medical information on the medical transaction device relating to the selected patient; and e. transferring the entered medical information from the medical transaction device to the computer server.